Functional Results Following Surgical Repair of Simultaneous Bilateral Quadriceps Tendon Ruptures

Chang, Edward S.; Dodson, Christopher C.; Tjoumakaris, Fotios P.; Cohen, Steven B.

doi:10.3810/psm.2014.05.2063

Cited by 13 publications

(19 citation statements)

References 28 publications

(28 reference statements)

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“…This result differs from that reported in studies by Monroy et al and Chang et al, which showed no difference in outcomes between bilateral and unilateral patients. 8,9 Limitations of our study include its retrospective nature. Our statistical analysis may have been skewed by the relatively small sample size of the bilateral group and relatively large sample size of the unilateral group.…”

Section: Discussionmentioning

confidence: 99%

“…reported a case-matched series of five bilateral-type injuries with no significant difference in patient-reported outcomes. 9 The purpose of this study is to share our experience in treating patients with BEMD. We hypothesized that patients with BEMD would have more medical comorbidities, more repair failures, and worse clinical outcomes than patients with a unilateral extensor mechanism disruption (UEMD).…”

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confidence: 99%

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Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?

et al. 2019

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Simultaneous bilateral extensor mechanism disruption (BEMD) is a rare condition, for which the relationship between comorbid conditions, complications, and clinical outcomes has not been well defined. We hypothesized that patients with BEMD would have more comorbidities, more repair failures, and worse clinical outcomes compared with patients with unilateral extensor mechanism disruption (UEMD). We performed a retrospective review of all adult patients seen at our institution for either a quadriceps or patellar tendon rupture between 2012 and 2017. Statistical analysis was conducted using Student's t-tests and Fisher's exact tests. Significance was defined as p < 0.05. Fourteen patients with BEMD and 221 patients with UEMD were included for comparison. The average length of follow-up was 268 days. Patients with BEMD had higher body mass indexes and higher American Society of Anesthesiologists scores than patients with UEMD. They also had worse Patient-Reported Outcomes Measurement Information System physical function scores, nearly four times the length of stay, and three times the rate of repair failures as patients with UEMD. At final follow-up, all 14 patients in the BEMD group were ambulatory and 9 of the 10 patients who were working prior to injury had returned to work. Simultaneous BEMD are rare injuries, occurring in only 6% of the current series. When treating these patients, orthopaedic surgeons should have a heightened awareness that they have more comorbidities, more failures, and worse functional outcomes than their unilateral counterparts.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?

et al. 2019

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“…Está descrito como sendo comum um atraso de diagnóstico em média de 65 dias, o que poderá ter repercussões no resultado cirúrgico e funcional dado serem lesões graves e incapacitantes. 3,6,11 FIGURA 1. Radiografia de face e perfil do joelho direito e esquerdo.…”

Section: Discussionunclassified

“…2 O diagnóstico e tratamento precoces são habitualmente descritos em associação a melhor resultado funcional. 11,13 Um atraso de tratamento de mais de duas semanas pode comprometer a reparação tendinosa primária pela sua retração. 13 No entanto, há autores que descrevem apenas uma pequena percentagem de re-rutura do tendão previamente operado, sem relação com o atraso de diagnóstico e tratamento cirúrgico.…”

Section: Discussionunclassified

“…3 Alguns autores não encontraram diferença no resultado funcional resultante de diferentes tempos de espera cirúrgica 2 ou quando em comparação com ruturas unilaterais. 11 No caso apresentado, o resultado pós-operatório foi globalmente satisfatório (com recuperação funcional sobreponível ao estado prévio ao traumatismo) apesar de a cirurgia ter sido realizada tardiamente.…”

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Rutura Crónica Bilateral do Tendão Quadricipital: Diagnóstico Tardio e Reparação Direta

Sapage

Mota

Branco

et al. 2019

Gaz Med

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A rutura bilateral do tendão quadricipital é uma lesão rara, não sendo muitas vezes diagnosticada na apresentação inicial.Apresenta-se o caso de um doente de 41 anos, género masculino, sem antecedentes médico-cirúrgicos ou medicação habitual, com diagnóstico tardio de rutura bilateral do tendão quadricipital (3 meses de evolução) após traumatismo de baixa intensidade. Foi submetido a reparação do tendão quadricipital com sutura transrotuliana e ancoragens à rótula bilateralmente. O pós-operatório decorreu sem intercorrências, tendo iniciado programa de reabilitação funcional com obtenção de arco de mobilidade de 0-120° aos 6 meses de seguimento.O diagnóstico de rutura bilateral do tendão quadricipital requer elevado grau de suspeição clínica pela sua raridade e variabilidade de apresentação. O tratamento precoce poderá estar associado a menor dificuldade cirúrgica e melhor resultado funcional. No presente caso foi possível a reparação direta com sutura transrotuliana do tendão e reforço de âncoras, com recuperação funcional sobreponível ao estado prévio ao traumatismo.

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High rates of return to play and work follow knee extensor tendon ruptures but low rate of return to pre-injury level of play

Haskel

Fried

Hurley

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Extensor mechanism ruptures (EMR) of the knee are rare but debilitating injuries that always require surgery to restore knee function. The purpose of this study was to systematically review the literature to ascertain the rate of return to play following patellar or quadriceps tendon ruptures. Methods A systematic literature search was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using the EMBASE, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of clinical studies reporting on return to play after patellar or quadriceps tendon repair. Statistical analysis was performed with the use of SPSS. Results Our review found 48 studies including 1135 cases meeting our inclusion criteria. There were 33 studies including 757 patellar tendon (PT) repairs, and 18 studies including 378 quadriceps tendon (QT) repairs. The overall rate of return to play for PT repairs was 88.9%, with 80.8% returning to the same level of play. The overall rate of return to play for QT repairs was 89.8%, with 70.0% returning to the same level of play. Among professional athletes, the overall rate of return to play after PT repair and QT repair was 76.9% and 70.9%, respectively. Following PT repair, 95.8% were able to return to work, and following QT repair, 95.9% were able to return to work. ConclusionThe overall rate of return to play was high following both PT and QT repairs. Moreover, a high percentage of those patients were able to return to their pre-operative level of sport with a low risk for re-rupture. Level of evidence Level IV.

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Functional Results Following Surgical Repair of Simultaneous Bilateral Quadriceps Tendon Ruptures

Cited by 13 publications

References 28 publications

Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?

Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?

Rutura Crónica Bilateral do Tendão Quadricipital: Diagnóstico Tardio e Reparação Direta

High rates of return to play and work follow knee extensor tendon ruptures but low rate of return to pre-injury level of play

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